Niyaz-e-Hussain AS Contribution Form
Enter your Niyaz message and contributor details, then choose a payment method and complete the required payment steps.
Contributor Information
First Name
*
Last Name
*
ITS Number
*
Email Address
*
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Jamaat Affiliation
Please Select
Anjuman-e-Burhani, Seattle
Anjuman-e-Badri, New York
Anjuman-e-Badri, Ottawa
Anjuman-e-Burhanee, Los Angeles
Anjuman-e-Burhani, Austin
Anjuman-e-Burhani, New Jersey
Anjuman-e-Burhani, Toronto
Anjuman-e-Ezzi, Boston
Anjuman-e-Ezzi, Washington D.C.
Anjuman-e-Fakhri, Minneapolis
Anjuman-e-Fakhri, Missisauga
Anjuman-e-Fakhri, Philadelphia
Anjuman-e-Fakhri, South Jersey
Anjuman-e-Hakimi, Bakersfield
Anjuman-e-Hakimi, Montreal
Anjuman-e-Hasani, Poconos
Anjuman-e-Husaini, Portland
Anjuman-e-Husami, Atlanta
Anjuman-e-Husami, South Carolina
Anjuman-e-Jamali, Miami
Anjuman-e-Jamali, North Carolina
Anjuman-e-Jamali, San Jose
Anjuman-e-Jamali, Vancouver
Anjuman-e-Mohammedi, San Antonio
Anjuman-e-Mohammedi, San Diego
Anjuman-e-Mohammedi, Virginia
Anjuman-e-Najmi, Dallas
Anjuman-e-Najmi, Detroit
Anjuman-e-Najmi, San Francisco
Anjuman-e-Qutbi, Orange County
Anjuman-e-Saifee, Chicago
Anjuman-e-Saifee, Edmonton
Anjuman-e-Saifee, Woodlands
Anjuman-e-Shujaee, Houston
Anjuman-e-Shujahee, North Chicago
Anjuman-e-Taheri, Columbus
Anjuman-e-Taheri, Plano
Anjuman-e-Vajihi, Calgary
Anjuman-e-Vajihi, Tampa
Non-US/Canada jamaat
Niyaz Contribution
Niyaz Contribution Amount
*
$53
$101
$253
$553
$1,053
$2,553
$5,553
Other
Would you like this Niyaz to be made on behalf of someone?
*
Yes
No
Name(s) for Niyaz
Payment
Please Note: Your Niyaz contribution is a voluntary, non-refundable charitable donation to Saifee Burhani Medical Association America (SBMAA), a 501(c)(3) nonprofit organization. No goods or services are provided in exchange for this contribution. Your donation may be tax-deductible to the extent permitted by law. Please retain your contribution receipt for your records and consult your tax advisor regarding your individual tax situation. By submitting this form, you acknowledge that your contribution is voluntary and non-refundable.
Payment Method
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Credit Card
Zelle
ACH Bank Transfer
Mail a Check
Total Niyaaz contribution amount
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